Case Presentation: A 73 year-old man presented with 2 weeks of difficulty completing multi-step tasks, e.g., getting into a car. At baseline, he was independent in instrumental activities of daily living. He had no other symptoms; he denied headache, weakness, numbness, vision changes, confusion, fevers, chills or weight loss. His history included non-alcoholic steatohepatitis with [...]

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with both of these. However, there is no evidence in literature to suggest clostridium difficile (C.Diff) diarrhea associated with these agents. [...]

Case Presentation: 23- year old Latino male with no known history presented to the ER complaining of worsening left eye pain. Patient stated that he has been cleaning manmade lakes and for one week started to have an erythematous and painful left eye associated with persistent frontal headache, and blurry vision. Patient endorsed recent diagnosis [...]

Case Presentation: A 53 yo female presented with a subacute syndrome of intermittent fevers, fatigue, heliotrope rash, weight loss, fingertip necrosis, and nodular skin lesions. Skin biopsy was positive for septal and lobular granulomatous panniculitis. Serology was positive for antinuclear antibody (ANA) and anti-ribonucleoprotein (RNP), negative for other vasculitis and rheumatologic autoantibodies. She was diagnosed [...]

Case Presentation: A 56 year-old man with a history of immunosuppressive therapy with prednisone and tacrolimus for a cadaveric kidney transplant presented with 1 month of personality change and lethargy. He was also noted to have generalized weakness and fatigue. He was initially seen 3 weeks prior to admission for these symptoms, which were attributed [...]

Case Presentation: Neisseria sicca is a gram-negative diplococcus that colonizes the nasopharynx. Severe infections, including bacteremia, from Neisseria sicca are very rare. We present a case of an immunocompromised 51-year-old female that was admitted with Neisseria sicca bacteremia complicated by an acute renal transplantation rejection.A 51-year-old female with a past medical history notable for type [...]

Case Presentation: A 64-year-old male with past medical history of hypertension (HTN), hyperlipidemia, coronary artery disease, and end stage renal disease, secondary to HTN, on hemodialysis presented with a 3-day history of nonproductive cough and malaise with no other associated symptoms. On admission vital signs were within normal limits; physical exam revealed decreased breath sounds [...]

Case Presentation: A 63-year-old male with a past medical history of end-stage renal disease status post living-related kidney transplant three years ago presented with dyspnea and joint pain. His immunosuppressive regimen included mycophenolate mofetil, prednisone, and belatacept, which was switched to everolimus due to concern for synovitis at outpatient rheumatology one month prior when he [...]

Case Presentation: A 60-year-old male presented with one week of new onset fevers and fatigue. Past medical history included primary sclerosing cholangitis, orthotopic liver transplant 12 years ago and Epstein-Barr virus (EBV) negative post transplant lymphoproliferative disease (PTLD) with partial response to single-agent Rituximab treatment one-year prior.The patient reported debilitating fatigue, daily low-grade fevers, night [...]

Case Presentation: A 78-year-old female with a history of uterine carcinosarcoma diagnosed two years ago presented to the ED with a primary complaint of orbital swelling, blurry vision, and diplopia OS. One week prior, she received her 5th and 1st cycle of Pembrolizumab and Zometa infusion, respectively for her uterine carcinosarcoma. Three days status post, [...]